Cancers account for 14.1 million morbidity and 8.2 million
mortality rate /year, 7.4 million (53%) in males and 6.7 million (47%) in females.
Cancer prevalence worldwide were 32.5 million as of 2012. The most common four
cancers worldwide is Lung cancer, breast cancer, Bowel cancer, Liver and prostate
cancer, those account for 46% of all cancers deaths.
About 30% of cancer deaths are due to the five leading
behavioral and dietary risks: high body mass index, low fruit and vegetable
intake, lack of physical activity, tobacco use, alcohol use.Tobacco accounts
for 20% of the cancer deaths and Cancer causing viral infections such as HBV/HCV
and HPV are responsible for 20% of cancer deaths in low- and middle-income
countries.
Cancers has mainly a genetic cause, but it does not mean it
is uncontrollable. Physical and environmental as well as behavioral factors
plays an important role in either activation or suppression those genes by a
process called epigenetic modification.
That mean that cancers to some extent could be preventable
and modified. Primary prevention focus mainly on behavioral and dietary factors
and secondary prevention depend on early detection and intervention as early as
possible. Increase avoidance of the risk
factors, Vaccinate against human papilloma virus (HPV) and hepatitis B virus
(HBV), Control occupational hazards, Reduce exposure to sunlight are all a primary
preventive measures. Visual inspection with acetic acid (VIA) for cervical cancer,
Pap test for cervical cancer, mammography screening for breast cancer are all
examples of secondary preventive measures.
WHO and the International Agency for Research on Cancer (IARC), the specialized cancer research agency of WHO, collaborate with other United Nations organizations and partners to:
coordinate and conduct research on the causes of human
cancer and the mechanisms of carcinogenesis; develop scientific strategies for cancer prevention and
control; generate new knowledge, and disseminate existing knowledge
to facilitate the delivery of evidence-based approaches to cancer control; develop standards and tools to guide the planning and
implementation of interventions for prevention, early detection, treatment and
care;facilitate broad networks of cancer control partners and
experts at global, regional and national levels; strengthen health systems at national and local levels to
deliver cure and care for cancer patients; and effective transfer of
best practice interventions to developing countries.
References:
1. Globocan 2012,
IARC
2. de Martel C, Ferlay J, Franceschi S, et al. Global burden
of cancers attributable to infections in 2008: a review and synthetic analysis.
The Lancet Oncology 2012;13: 607-615.
Ola, bring your own critical analyses to the BLOG. By now, we should go beyond the copy paste method to more critical and involved analyses
ReplyDeleteThanks prof Lala. I want here to elaborate the magnitude of cancer problem worldwide, and explain the role of global organization to manage the problem. Also I want to focus on our role of prevention as control for this problem . It has been known for a while that cancer has an only genetic base and we have nothing to do with it. But nowadays the epigenetic role elaborate the causation effect of behavior and environmental role in the cancer. These factors that we can manage control the incident of the disease as well as affecting the mortality
ReplyDeleteOla, I like that you brought up this issue of cancer. Currently, I teach Contemporary Women's Health for the Health & Kinesiology department and this past week my lecture was on Cancer in Women. From preparing that lecture and just reading you blog post, I have been thinking about cancer a lot recently. I am very intrigued about the marketing surrounding different types of cancer, most notably breast cancer campaigns. I find it frustrating that breast cancer is so well marketed with the "Save the Tatas" movement, while other just as important cancers go unnoticed and unfunded. I am wondering about your views on these marketing campaigns. Do you think that they help spread awareness of the disease, or just a catchy logo to put on a shirt? I remember in class one evening Jill saying something about how the AIDS shirts in Africa became so popular that everyone, even non-AIDS individuals began wearing them because it was cool. Do you think that trend is occurring with some cancers?
ReplyDeleteThank you Hannah. This is right for breast cancer campaigns, but I can not disagree with these campaigns. Indeed, I think we should do more for other important cancers as we do with breast cancer. From patients point of view, these campaigns do a lot for them psychologically and socially, it raises the awareness to a degree which reverse the disease stigma to an honor and picture the patients as a heroes, and the patients need that through their trip of suffering. This campaigns also raises a lot of money which benefit the patients and the research. I hope we can find a way to raise awareness for other cancers as we do with breast cancer. Innovative campaigns may be one way to go from.
ReplyDeleteLike many people my age (mid-30's), I never gave cancer much of a thought until people I knew started getting it. The other day, a friend my age was diagnosed with breast cancer. I have a friend who has Stage 4 at 40 years old, also breast cancer. And my friend Scott has Stage 4 stomach cancer and is a vegan elite athlete. He even made the cover of Runner's World this month for his amazing story: http://www.runnersworld.com/runners-stories/cover-contest-finalist-scott-spitz. My father is a prostate cancer survivor, one of my office mates is also a prostate cancer survivor and the other one has Stage 4 breast cancer. It seems now like it's everywhere, and many of these people don't fit the poor-eating, no exercise, smoker profile. Are we perhaps marketing too much this idea of connections between health choices and cancer if only 30% of deaths are related to behavior? If so, what other marketing should we be doing?
ReplyDeleteJill you raised a very good point view. Like you, I have some friend who are still in their thirty's and have cancers. The thing is that those behavior related risk factors are the most easy and manageable ones in relation to the molecular and the biomedical bases of cancer. That is why we focus on them especially for the primary prevention. Molecular and genetic modification to prevent cancers are much more costly and needs a lot of interventions and clinical research that takes a lot of time and not that easy. We still need to focus on both behavior and Biomedical prevention researches. The trends in incidence of cancer like different distribution between populations and older or younger age, direct us to the environmental and behavioral factors rather than the genetic factors.
ReplyDeleteJill, to add to what Ola said, there are many contributors to the etiology of cancer. In my pharmacotherapeutics class, we learned that >4 hours of exercise each week in reproductive years can decrease a patient's risk of developing breast cancer by 60%. In addition, if a patient has a BRCA1 or BRCA2 mutation, which is often genetic, they will have a 40-80% chance of developing breast cancer in their lifetime. If it is possible for us to reduce our risk of cancer by 60%, we should definitely be taking these measures and encouraging others to do so. There is, of course, still the chance that if people take all precautions to prevent cancer, it will still occur. There are just some things we can not control. This is why screening can be useful. Again, in class we learned that with cervical cancer, mortality has been reduced by 75% in developed countries due to effective screening programs. When cervical cancer is caught early, there is over 93% cure rate.
ReplyDeleteThe BRCAs are interesting because the behavior change is sooooo high-income-country-specific. My friend had a mastectomy after it was located in her family, and spends an enormous amount of time dedicated to activism around getting screened. So I guess that's a good one that doesn't necessarily involve behavior change, but does involve having the money to pay for the screening.
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